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Table 28-3

PreparationIndicationsWeaknesses
Topical antibiotics

Fusidic acid

(Fucidin ointment®)

Mupirocin

(Bactroban ointment®)

Silver sulfadiazine

(Flamazine®)

Staphylococcal infections

Gram-positive and some gram-negative organisms

Treatment of nasal staphylococcal carriage

Pseudomonal infection and some prophylaxis against staphylococcal infection

Resistance

Resistance

Minimal absorption and renal impairment when applied to extensive burns

Topical antibiotics used in the treatment of acne

Tetracyclines

Erythromycin

Clindamycin

Acne

May be used in combination with keratolytics such as benzoyl peroxide

Resistance

May stain clothing yellow

Topical antifungals

Allylamines

Terbinafine cream

(Lamasil cream®)

Imidazoles

Clotrimazole (Canesten®)

Econazole

Ketoconazole

Miconazole

Tioconazole

Amorolfine

(Loceryl lacquer®)

Fungicidal against dermatophyte infectionsIneffective against dermatophyte infections of the nails and scalp

Fungistatic

Active against Candida and Pityrosporum

May be used in combination with topical steroids

Used in the treatment of intertrigo, pityriasis versicolor, and some dermatophyte infections

Concurrent use of topical steroid may mask infection

Fungistatic

Used in the treatment of onychomycosis

Some activity against Scytalidium

Synergistic activity with systemic antifungals

Poor cure rates in dermatophyte infections affecting the nail matrix when used as sole therapy
Topical antivirals

Aciclovir cream

(Zovirax®)

Penciclovir cream (Denavir®)

Used to treat labial and genital herpes simplexNeeds to be applied as early as possible in the episode for maximum benefit
Anti-parasitic agents

Permethrin

Malathion

Ivermectin

5% cream used in the treatment of scabies and pubic lice. 1% rinse used to treat head lice

Used in the treatment of scabies, head lice, and pubic lice

1% cream used to treat rosacea, cutaneous larva migrans

Require two treatments one week apart

Alcoholic lotions can irritate skin and can exacerbate eczema